Cook Hospital Pharmacy
Organization Active NPI Pharmacy · Cook, MN
NPI 1093850844 · NPPES record last updated Feb 27, 2019
Key facts
- NPI
- 1093850844
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 260751-1 (MN)
- Legal business name
- COOK HOSPITAL PHARMACY
- Practice address
- 10 5TH St SE
Cook, MN 55723-9702 - Phone
- (218) 666-6229
- Fax
- (218) 666-6249
- NPI assigned
- Feb 20, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- COOK HOSPITAL
Authorized official
- Name
- Marie Ljosenvoor, PHARMD
- Title
- Director of Pharmacy
- Phone
- (218) 666-6229
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Cook Hospital Pharmacy
- Part of
- Cook Hospital Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 260751-1 | MN | Yes |
| Community/Retail Pharmacy | 3336C0003X | |||
| Institutional Pharmacy | 3336I0012X | |||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
10 5TH St SE
Cook, MN 55723-9702
Mailing address
10 5TH St SE
Cook, MN 55723-9702
Phone (218) 666-6229
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 752547800 | Medicaid | MN | |
| 2418716 | Other | MN | NCPDP |
Other providers in Cook, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.